Voices from the Picket Lines


The strike of 2000 Kaiser Permanente mental health care providers is
now in its seventh week. On Saturday, votes were counted; the tally was
overwhelming, 1349 to 222 to continue the strike.
Why? Here’s Jane Kostka, a steward with the National Union of
Healthcare Workers (NUHW):
“We’re out here on the picket line today because of professional
ethics denied. The strike is not about money. In fact, over the weekend on
Saturday Kaiser made us a conditional offer to raise our pay if we would
accept pretty much leaving the working conditions and the patient care at
status quo. And that is not acceptable to us. We are striking because it’s
one last resort to get Kaiser to understand that we need to see our patients
at a frequency that helps the patients actually get better. And we need to
have enough time in the day to take care of the patients we already have.
We need Kaiser to hire more therapists and to give them a workload that is
sustainable so that those therapists stay on the job and do not leave
because they are burned out
“We have many, many patients who have suffered trauma or abuse.
What they need is someone on their side They need someone who is
accessible, someone who they can talk with regularly to help them deal
with the fear and with the feeling that their life could just close in on them.
When we’re working eight, nine, ten weeks between appointments, they
don’t have that backup and they wind up getting more depressed, more

anxious, calling us, emailing and we don’t have enough time in our daily
schedule. I and many of my fellow therapists work late every day just to call
back those of our patients who are the most distressed because we just
can’t leave them hanging there with no answer between one day and the
next.”
This is from Kostka’s speech at the NUHW’s rally in Sacramento.
NUHW members have been picketing Kaiser medical centers and clinics in
Northern California. They’ve held rallies in Santa Rosa and Sacramento,
including a Labor Day rally at Kaiser’s flagship medical center in Oakland.
It’s become a cliché to say there is a mental healthcare crisis in this
country; everyone from the President down has joined the chorus –
depression, anxiety, addiction, suicide, something has to be done. The
difference here is that these strikers are doing something about it, and to
their credit virtually every mental health care advocate in California has
come out in support, as has the San Francisco Central Labor Council, the
San Francisco Board of Supervisors (the Board discussed the strike on
Tuesday, listening to many NUHW members), and an array of unions. The
Massachusetts Nurses Association sent $25000.
Just this year, the California State Senate passed a law sponsored by
NUHW, SB 221, which requires HMOs like Kaiser to provide follow-up
mental health care appointments within 10 business days if recommended
by a therapist. Its purpose was to put some teeth into existing legislation.
Readers here will know that Kaiser Permanente is a behemoth
amongst this country’s corporate, “not for profit” health care providers, with
39 hospitals and 700 medical facilities, and 9.4 million “members” who pay

for Kaiser’s services.. It’s net worth in 2021 was $43.3 billion Its CEO Greg
Adams received $17.3 million in total compensation in 2020. He and the
top 100 executives have the benefit of eight separate retirement plans.
The NUHW represents 4000 Northern California mental health
technicians, clinicians (psychologists, social workers, psychiatric nurses
and chemical dependency counselors). They have been bargaining with
Kaiser since July.
In the face of this, Kaiser is defiant; it attends bargaining sessions,
though most often with nothing on offer. It insists that SB 221 (of which it is
out of compliance) and anything related to staffing and work load is off
limits. It seems intent on using its vast wealth to outlast its workers. It also, I
suspect, counts on a divided workforce; the majority of patients will receive
care, only those seeking mental healthcare will suffer.
This can change, however unlikely. In Santa Rosa nurses from the
emergency department joined the pickets. Here’s a nurse speaking out.
“I’ve worked here in the Emergency Department for five years. I’d just
like to say that I think this strike is a righteous strike and what you guys are
doing is fantastic and I can’t wait to join you guys out here soon. We
continuously see patients come in with the same triage note. ‘I had an
appointment made for me in three weeks and I’m in crisis right now and I
need to see a therapist’ and instead of getting that opportunity people are
making attempts on their lives and then coming to the emergency room and
then sit in a box. It’s not therapeutic and it’s disgusting and Kaiser needs to
do better and so I really appreciate the sacrifice you’re making here today

and again can’t wait to join you out here when we get on strike as well
when we can combine and put the hurt on them.”
There are specific reasons, I might add here, that Kaiser has
consistently played hard ball (and worse) with NUHW – clearly apparent in
comparison with any of the other half dozen unions that represent Kaiser
workers.
First, certainly, NUHW is a union that is present on the “shop
[hospital] floor,” that fights for its members, that doesn’t do concessions.
Second, NUHW’s Kaiser’s workers have steadfastly refused to give
up their watchdog role – their responsibility to their patients and to the
community; they consistently rejected Kaiser’s insistence on “gag rules”
imposed in contracts and elsewhere. Why? The union and its members
have from the beginning joined other mental health campaigners in
advocating for patients and in exposing Kaiser’s negligence, while calling
for parity with medical health care and supporting the rights of mental
health care patients.
(It might be added here, alas, that Kaiser may be a pacesetter, but its
far from alone. In denying its members mental health care they’ve paid for,
it’s just a leader of the pack. See New York Times feature, “Profits over
Patients,” a report about how on the medical side, patients are denied
entitlements, billed in defiance of existing regulations, then, when these
bills are not paid, sends them into collection, well knowing what this means
to working class people.
https://www.nytimes.com/2022/09/24/business/nonprofit-hospitals-poor-
patients.html?searchResultPosition=1)

No wonder then that Sabrina Chaumette, a steward at the Oakland
Center, says:
“During the pandemic we have had losses on a number of different fronts.
People suffered all at once. Consider this like the great depression, people
suffered illness, death, job loss, learning that millions of people had died
from COVID or long Covid. They suffered isolation, loss of community, loss
of purpose, loss of meaningful work, loss of housing. Substance abuse use
went up, as people tried to survive and cope. Rates of suicide went up;
rates of depression went up, anxiety went up, especially social anxiety.
Imagine being home for three years and somebody tells you gotta get out
of the house. So social anxiety went up and so did suicide. If this were a
war, which I feel it is, this is what is considered collateral damage, they can
afford to lose the ones with mental illness.”
The union doesn’t plan on losing. Sophia Mendoza, NUHW’s
Secretary Treasurer, puts it this way: “If they won’t collaborate with us, it’s
going to get worse, clinicians are already leaving. No one’s going to want
to work at Kaiser.”

How you can help

A note from the union: We know Kaiser’s playbook: Cancel thousands of
appointments, make patients suffer, blame the therapists, and reject every
proposal therapists make to improve care.

Here’s how you can make Kaiser finally prioritize mental health care:

1. Follow and share our fight on Twitter, Facebook and Instagram.
2. Join therapists on the picket line:
3. Don’t let Kaiser get away with canceling appointments. Kaiser is required
   by law to provide the same level of care during a strike no matter how
   much it costs them.

Cal Winslow’s latest book is, Radical Seattle, the General Strike of 1919.

He can be reached at cwinslow@mcn.org

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